| NPI | 1598758633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: NE 27788) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology (Licence: IA 22918) |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2014-03-31 |